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A method for establishing a non-invasive risk assessment model for liver surgery

A technique for surgical treatment and liver, applied in the field of liver surgical treatment evaluation model, can solve problems such as portal vein pressure that cannot be truly reflected, and achieve easy-to-obtain results

Inactive Publication Date: 2015-11-18
SECOND MILITARY MEDICAL UNIV OF THE PEOPLES LIBERATION ARMY
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

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Problems solved by technology

Therefore, the indirect measurement method cannot truly reflect the portal vein pressure, and it is also an invasive measurement method, and there are certain risks in the examination and treatment
[0013] In conclusion, there are certain deficiencies in the evaluation methods of liver surgery that are still in use at present, and need to be improved.

Method used

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  • A method for establishing a non-invasive risk assessment model for liver surgery

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Experimental program
Comparison scheme
Effect test

Embodiment 1

[0030] Example 1 Establishment of Portal Pressure Prediction Equation

[0031] (1) Collection of routine clinical examination indexes before operation: collect the clinical indexes of liver cancer patients undergoing surgical treatment. The clinical data of 200 patients with liver cancer (including 120 patients with liver cirrhosis) who received surgical treatment were collected, including clinical routine serological examination indicators and imaging data. Clinical routine inspection indicators are routine inspection items that must be done before surgery for patients undergoing surgical treatment.

[0032] (2) Measurement of portal venous pressure during operation; portal venous pressure was measured through omental vein during operation. Omental vein measurement is currently recognized as an objective and accurate method for measuring portal venous pressure, and records should be made.

[0033] (3) Establishment of portal pressure prediction equation: Apply multiple regre...

Embodiment 2

[0035]Example 2 Verification of Portal Pressure Prediction Equation

[0036] In order to verify whether the portal vein pressure equation can accurately predict the portal vein pressure according to several related indicators, the inventors conducted clinical verification.

[0037] 200 cases of clinical patients were collected and divided into 4 groups, 50 people in each group, and the collection method was the same as before. Before measuring the pressure during the operation, the inventor calculated the portal vein pressure value according to the equation, which was recorded as the calculated pressure. The portal vein pressure value measured during the operation is recorded as the measured pressure. Compare and analyze the calculated pressure with the portal pressure measured during the operation, see Table 1 for details

[0038] Table 1 Comparison table of calculated pressure and measured pressure of portal vein (mean ± standard deviation)

[0039]

Calculati...

Embodiment 3

[0042] Example 3 Application of non-invasive evaluation model map for liver surgery

[0043] The clinical data of the postoperative liver cancer patients were collected. By comparing the range of portal vein pressure and surgical prognosis, the relationship between portal vein pressure and liver surgical resection tolerance is calculated by applying relevant statistical methods, so as to determine the safe resection range according to portal vein pressure.

[0044] Liver surgery risk assessment model map, such as figure 1 shown.

[0045] Wherein, the portal vein pressure is less than 12cmH 2 O, the tolerable resection volume is 40%-60% of the total liver volume; the portal vein pressure is 12-19cmH 2 O, the tolerable resection volume is 30%-40% of the total liver volume; the portal vein pressure is 19-23cmH 2 O, the tolerated resection volume is 20%-30% of the total liver volume; the portal pressure is greater than 23cmH 2 O, the tolerated resection volume is less than 20...

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Abstract

Disclosed is a method for establishing a noninvasive evaluation model for liver surgical treatment risks. The method comprises collection of clinical data before surgery, measurement of the portal vein pressure during surgery and establishment of a portal vein pressure prediction equation. The establishment of the liver surgical treatment risk noninvasive evaluation model includes that when the portal vein pressure is smaller than 12 cm H2O, the tolerant resection volume is 40% to 60% of the liver total volume; when the portal vein pressure is between 12 cm and 19 cm H2O, the tolerant resection volume is 30% to 40% of the liver total volume; when the portal vein pressure ranges from 19 cm to 23 cm H2O, the tolerant resection volume is 20% to 30% of the liver total volume; and when the portal vein pressure is larger than 23 cm H2O, the tolerant resection volume is smaller than 20% of the liver total volume. According to the method for establishing the noninvasive evaluation model for liver surgical treatment risks, utilized clinical indicators before surgery are routine inspection items and are noninvasive. The accuracy rate of the portal vein pressure prediction equation is more than 75%, and the deviation is within 2 cm water columns.

Description

technical field [0001] The invention relates to the field of liver surgery, and is a simple, effective and non-invasive evaluation model for liver surgery treatment. Background technique [0002] Surgery is still the main method for the treatment of liver cancer at present, but how to choose a reasonable surgical method for a specific patient is still one of the difficulties in liver surgery; especially for liver cancer patients with liver cirrhosis, how to accurately evaluate the liver reserve function before operation and choose an appropriate surgical method. The correct surgical method is a problem that every liver surgeon must face. In China, there are 2 / 3 of the patients with hepatitis B virus infection in the world, and most of the patients with liver cancer are accompanied by post-hepatitis B cirrhosis. Such patients are prone to complications of varying degrees after surgery, and some patients even suffer from postoperative liver failure. Therefore, there is a nee...

Claims

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Application Information

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Patent Type & Authority Patents(China)
IPC IPC(8): G06F19/00
Inventor 吴东陈绪涛翟健张一军沈峰吴孟超
Owner SECOND MILITARY MEDICAL UNIV OF THE PEOPLES LIBERATION ARMY
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